Colorectal Cancer Treatment Costs Vary Widely

THURSDAY, Nov. 20 -- The cost of treating colorectal cancer can vary by tens of thousands of dollars per patient.

To reach that conclusion, researchers compared the eight most commonly prescribed therapeutic regimens used to treat more than 400 patients at 115 ambulatory care centers across the United States.

The regimens, which included supportive agents often required to ease treatment-related side effects such as nausea, ranged from the older chemotherapy cocktail 5-FU/LV (5-fluoroucil and leucovorin calcium) to newer therapies that include bevacizumab (brand name Avastin), which choke off a tumor's blood supply.

"The total cost of chemotherapy to treat colorectal cancer may differ by as much as $36,999 per patient, depending on the regimen," study senior investigator Dr. Gary Lyman, an oncologist and health outcomes researcher at the Duke Comprehensive Cancer Center, said in a Duke news release. "We know that some therapies are more promising and effective, in general, than others, and cost variation raises many questions about what kind of care patients are receiving and whether this economic burden is matched by significant clinical advancements, especially with regard to quality of life."

The study was published in the November issue of the American Journal of Managed Care.

Each year in the United States, almost 150,000 cases of colorectal cancer are diagnosed, and about 56,000 people die of the disease. Colorectal cancer is the third most common kind of cancer in the United States and the second leading cause of cancer death, the researchers said.

"The cost of treating colorectal cancer has skyrocketed. We have seen similar trends in terms of rapidly rising costs of drug development in breast cancer and other malignancies, but nowhere has this been more striking than in the management of colorectal cancer," Lyman said.

Life-extending therapies introduced over the past several years can almost double survival time in some cases and have led to a 340 percent increase in chemotherapy costs for colorectal cancer treatment, the study found.

"For many of these colorectal cancer patients, depending on how advanced their disease is, we may be talking about buying a few months. And these rapidly increasing costs have raised ethical questions about whether such sums of money should be dedicated to treatments that may modestly prolong life but not offer increased cure rate," Lyman said.

He added that the study findings suggest new strategies may be necessary to limit the economic impact of newer colorectal cancer therapies, such as easing restrictions on the federal government's ability to negotiate drug prices and asking drug makers to reassess their pricing policies.